Child ; Child, Preschool ; Female ; Flow Cytometry ; methods ; Humans ; Infant ; Male ; Thrombasthenia ; classification ; diagnosis

Background Researches showed that multifocal electroretinogram (mfERG) is able to assess the retinal function in the eyes with acute Vogt-Koyanagi-Harada ( VKH ) syndrome. But the mfERG characteristics of convalescence stage of VKH are still below clear. Objective Present study was to compare and follow up the variation process of visual acuity and mfERG in acute and recovery stages of VKH syndrome. Methods This was a clinic-based retrospective study. Visual acuity, mfERG and fundus fluorescence angiography ( FFA ) were recorded from 35 eyes of 18 acute VKH cases. The period of follow-up in recovery stage lasted about 18 months with the repetitive recording results for 4 times. Results In this study, the visual acuity range in acute stage VKH was 0. 01 to 1.0, and 91.4% (32/35 eyes) was below 0.6. Compared with normal control group, the visual acuity was significantly decreased (P＜0.01). The response densities (amplitudes) of N1 ,P1 waves of the first-order kernel were significantly lowed in all the 6 rings,and the implicit times of 1-4 rings of both waves were significantly prolonged in acute VKH eyes(P＜0. 05). The abnormalities of retinal function showed a regional difference at the posterior pole retina with the dominant change in the first ring,showing a cutting off78% in the P1 amplitude. The abnormal degree of mfERG was more serious as the the increase of retinal eccentricity. In 2 months of convalescence after glucocorticosteroids therapy,the range of visual acuity were 0. 1-1.2 ,and the amplitudes of N1, P1 of 1-2 rings were greatly elevated in comparison with acute on-set (P＜0. 05 ). However, there was still a remarkable difference in the amplitudes of from 1 through 6 rings,comparing with normal. The response density of P1 wave from whole recording region was only 44% of normal. Though the visual acuity was stable during the follow-up duration, a decreasing tendency in N1 and P1 amplitudes were seen. The implicit times of both wave shortened only in 1-3 rings in recovery stages of VKH (P＜0.05). Conclusion VKH syndrome cause serious damage of posterior retinal function.Macular region is the site with greater retinal functional lesion and restore before and after medication. This hardly recovery of retinal function can last over one and half year,even satisfied visual acuity is stable after proper treatment.

In this paper, based on the special influence of supramolecular chemistry on the basic theory of Chinese medicines ( CM) , the authors further analyzed the history of meridian tropism and natural origins of CM organisms and explained CM ingredients and the universal regularity of the automatic action of the supramolecular "imprinting templates" hole channel structure. After entering human bodies, CMs, as the aggregation of supramolecular "imprinting templates" , automatically seek supramolecular subjects that are matched with their "imprinting templates" in human meridians and organs for the purpose of self-recognition, self-organization, self-assembly and self-replication, so as to generate specific efficacy in meridians and organs, which is reflected as the meridian tropism phenomena at macro level. This regularity can be studied by in vitro and in vivo experimental studies. In vitro methods are mostly supra molecular structure analysis and kinetic and thermodynamic parameter calculation; Whereas in vivo methods are dominated by the analysis on object component distribution, chromatopharmacodynamic parameters and network chromatopharmacodynamic parameters; Particularly, the acupoint-medicine method can simplify to study the supramolecular subject-object relations. Consequently, CM's'meridian tropism reveals the universal regularity for interactions of macromolecular and micromolecular "imprinting templates" of subjects and objects in natural organisms. As the first barrier for the material base of the CM theory and breakthrough in the modernization of the basic CM theory, meridian tropism plays an important role in studies on basic theories of the basic CM theory.
Acupuncture Points ; Drug Therapy ; Drugs, Chinese Herbal ; chemistry ; Humans ; Medicine, Chinese Traditional ; Meridians

Objective To-identify the factors associated with radiation-induced liver disease (RILD) and to describe the probability of RILD using the Lyman normal tissue complication(NTCP) model for primary liver carcinoma(PLC) treated with hypofractionated conformal therapy (CRT).Methods A total of 109 PLC patients treated with hypofractionated CRT were prospectively followed according to the Child-Pugh classification for liver cirrhosis,93 patients in class A and 16 in class B.The mean dose of radi- ation to the isocenter was (53.5?5.5) Gy,fractions of (4.8?0.5) Gy,with interfraction interval of 48 hours and irradiation 3 times per week.Maximal likelihood analysis yielded the best estimates of parameters of the Lyman NTCP model for all patients;Child-Pugh A and Child-Pugh B patients,respectively.Results Of all the patients,17 developed RILD (17/109),8 in Child-Pugh A(8/93 ) and 9 in Child-Pugh B(9/ 16).By multivariate analysis,only the Child-Pugh Grade of liver cirrhosis was the independent factor (P= 0.000) associated with the developing of RILD.The best estimates of the NTCP parameters for all 109 pa- tients were n=1.1,m=0.35 and TD_(50) (1)=38.5 Gy.The n,m,TD_(50) (1) estimated from patients with Child-Pugh A was 1.1,0.28,40.5 Gy,respectively,compared with 0.7,0.43,23 Gy respectively,for patients with Child-Pugh B.Conclusions Primary liver cancer patients who possess Child-Pugh B cirrho- sis would present a significantly greater susceptibility to RILD after hypofractionated CRT than patients with Child-Pugh A cirrhosis.The predominant risk factor for developing RILD is the severity of hepatic cirrhosis in the liver of PLC patients.

Objective:To summarize our experience in perioperative anesthetic management for fulminant hepatic failure (FHF)patients receiving liver transplantation.Methods:The clinical anesthetic data of 48 FHF patients receiving orthotopic liver transplantations(OLT)from January 2006 to January 2007 were retrospectively analyzed,and the anesthetic management expe- rience was summarized.General anesthesia was applied;the hemodynamics was monitored during the operation and doses of adrenaline and phenylephrine were adjusted according to the monitoring results.Blood samples were obtained before operation, before anheptic,30 min after anhepatic phase,5 min before neohepatic phase,and 5 min,30 min and 60 min after neohepatic phase for blood gas and electrolyte analysis and for determination of coagulation function;the drugs were subsequently adjusted according to analysis results.Results:All the 48 patient underwent successful anesthetic management and there was no death dur- ing opearation.The average blood loss during operation was(5 219?478)ml.Mild alkalosis,hypokalemia,hyponatrium,and hy- pocalcemia were present before operations,pH,BE and HCO_3~- were obviously reduced 30 min after anhepatic phase and in- creased 60 min after neohepatic phase.Kalemia was obviously increased 30 min following anhepatic phase and began to increase 60 min following neohepatic phase.Calium concentration was decreased at the end of preanhepatic phase(P

Objective To observe the safety and efficacy ofintra-arterial thrombolysis guided by CT perfusion in patients with anterior circulation ischemic stroke presenting with symptoms longer than 6 h.Methods The clinical data of patients with anterior circulation ischemic stroke presenting with symptoms longer than 6 h (n=36) and shorter than or equal to 6 h (n=30),performed intra-arterial thrombolysis in our hospitals from July 2003 to December 2012,were retrospectively evaluated.Patients of the former group were evaluated the ischemic penumbra and core region of infarction and the mismatch between the two regions based on CT perfusion.The clinical features,clinical outcomes and complications were compared between the two groups.Results As compared with those in patients of symptoms shorter than or equal to 6 h,the early neurological improvement rate (13.3％ vs.22.2％) and long-term neurological improvement rate (86.7％ vs.77.7％),recanalization rate (80.0％ vs.88.9％) and 3-month mortality (6.7％ vs.16.7％) of patients of symptoms longer than were not significantly different (P=0.665,P=0.665,P=0.639 and P=0.607).Conclusions To patients with anterior circulation ischemic stroke presenting with symptoms longer than 6 h,the neurological function at 3-month significantly improves after intra-arterial thrombolysis guided by CT perfusion.Although the incidence of symptomatic intracranial hemorrhage increases,the mortality rate does not significantly increase.

OBJECTIVETo investigate the effect of X-rays on expression of caspase-3 and p53 protein in EL-4 cells and its implications in induction of apoptosis and polyploid cells.

METHODSMouse lymphoma cell line (EL-4 cells) was used. Fluorescent staining and flow cytometry analysis were employed for measurement of protein expression, apoptosis, cell cycle, and polyploid cells.

RESULTSThe expression of caspase-3 protein increased significantly at 8 h and 12 h, compared with that of sham-irradiated control (P<0.05, respectively) and the expression of p53 protein increased significantly at 2, 4, 8, 12, and 24 h, compared with that of sham-irradiated control (P<0.05-P<0.01) in EL-4 cells after 4.0 Gy X-irradiation. Apoptosis of EL-4 cells was increased significantly at 2, 4, 8, 12, 24, 48, and 72 h after 4.0 Gy exposure, compared with that of sham-irradiated control (P<0.05-P<0.001). G2 phase cells were increased significantly at 4, 8, 12, 24, 48, and 72 h (P<0.05-P<0.001). However, no marked change in the number of 8 C polyploid cells was found from 2 to 48 h after 4.0 Gy exposure.

CONCLUSIONThe expressions of caspase-3 and p53 protein in EL-4 cells are induced by X-rays, which might play an important role in the induction of apoptosis, and the molecular pathway for polyploid formation might be p53-independent.

Animals ; Caspase 3 ; metabolism ; radiation effects ; Caspases ; metabolism ; radiation effects ; Cell Line, Tumor ; Mice ; Tumor Suppressor Protein p53 ; metabolism ; radiation effects ; X-Rays

OBJECTIVETo evaluate the toxicity and efficacy of primary liver cancer (PLC) treated by hypofractionated three-dimensional conformal radiotherapy (3DCRT) and investigate the prognostic factors.

METHODSBetween April 1999 and August 2003, 128 PLC patients received hypofractionated 3DCRT. According to UICC/AJCC staging system, there were 83 T3 patients, 45 T4, with none of them having lymph node metastasis. The mean value of gross tumor volume (GTV) was (458.92 +/- 429.8) cm(3) (6.2-2097 cm(3)). Thirty-four patients had portal vein tumor thrombosis (PVTT). 108 patients had Child-Pugh Grade A liver cirrhosis and 20 Child-Pugh Grade B liver cirrhosis. All patients received a total dose of (53.6 +/- 6.6) Gy/4-8 Gy per fraction/3 fractions per week. Forty-eight of these patients received 3DCRT combined with transarterial chemoembolization (TACE).

RESULTSSeven patients died within 3 months after the treatment were dismissed from the series. The response rate (CR + PR) was 55% (67/121). The overall 1-, 2-, and 3-year survival rate was 65.0%, 43.3%, and 33.1%, respectively. T stage (P = 0.001), GTV (P = 0.0001), PVTT (P = 0.0001) and Child-Pugh Grade (P = 0.0001) had significant impact on the overall survival. However, only GTV and Child-Pugh Grade were independent significant prognostic factors by Cox-regression analysis, (P = 0.044 and P = 0.015).

CONCLUSIONT stage, GTV, PVTT and Child-Pugh Grade have significant impact on the overall survival in primary liver cancer patients treated by three-dimensional conformal radiotherapy. But only GTV and Child-Pugh Grade are independent prognostic factors.

Adult ; Aged ; Carcinoma, Hepatocellular ; radiotherapy ; Female ; Follow-Up Studies ; Humans ; Imaging, Three-Dimensional ; Liver Neoplasms ; radiotherapy ; Male ; Middle Aged ; Prognosis ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Conformal ; methods ; Regression Analysis ; Retrospective Studies

Traditional Chinese medicine (TCM) has been formed and developed in medical practices over thousands of years, while biomechanics as a new research direction in TCM has been developing rapidly in recent years. Biomechanics in TCM encompasses abundant contents, such as hemodynamics in meridians, substance transport of Yin-Yang and the Five Elements, hemodynamics of pulse manifestation, heat conduction in tongue diagnosis, biomechanics of orthopaedics and traumatology, mechanics of acupuncture, massage and manipulation, TCM medical device, biomechnopharmacology and etc. Journal of Medical Biomechanics has published some papers about TCM biomechanics in the past years, and in this issue, a special column of TCM biomechanics in three research directions is organized, including massage and manipulation, fracture fixator by TCM treatment, and Tai Chi Quan, so as to arouse readers’ interest in TCM biomechanics.